维持性血液透析颈内静脉导管相关感染的护理

Nursing experience of the infections relating to internal jugular vein catheterization in maintenance hemodialysis patients

目的探讨血液透析患者留置颈内静脉导管相关感染并发症的原因与护理对策。方法对30例维持性血液透析颈内静脉留置导管的患者观察1年,分析导管相关感染的发生原因、预防及处理方法。结果共6例患者出现导管出口处皮肤与隧道浅层感染(8例次),该6例患者均年龄较大,病情相对较重,生活自理能力较差;发生原因均与局部污染后处理不当、不及时相关。结论导管出口处局部污染是导管相关感染的常见原因之一,培养患者良好的卫生习惯、保持局部清洁、及时正确处理是预防的关键。

Objective To investigate the causes and nursing strategies of infections relating to indwelling internal jugular vein catheters in maintenance hemodialysis(MHD) patients. Methods Thirty MHD patients with internal jugular vein indwelling catheters were observed for one year, and the causes,prevention and treatment of catheter-related infections were analyzed. Results In this group, 6 patients had skin infection at the exit sites of the catheters and the shallow layer of the tunnels(8 times). Improper management and local contamination of the exit sites were the causes of the infections. Conclusions Local contamination at the exit of the catheter was one of the common causes of catheter-related infections.Hygiene habits of the patients, local clean of the exit sites and correct treatment of the infections are essential to prevent these infections.